Care Home: Boulters Lock Residential Home

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What the care home does well The Annual Quality Assurance Assessment (AQAA) was completed by the home and returned to the Commission within the agreed time frame. The AQAA noted that the home uses a person centred approach and care plans are reviewed on a monthly basis. Staff are trained to treat service users as individuals and maintain the privacy and dignity of service users. The home has a policy on the safe administration of medication, only those trained to administer medication are allowed to do so, and the manager ensures policies and procedures are followed. One inspector looked at a sample of care plans whilst these were being up-dated by staff. They were found to be well done, and contained a good level of detail about residents` needs. A medication administration session was observed and found to comply with and reflect the home`s policy for the safe administration of medication. A recent pharmacist`s visit report was seen and it had noted a few areas for improvement. The manager said these actions had now been completed. The AQAA noted there are a number of ways for service users to air their views or to make a complaint, including regular service user meetings. There is a clear and accessible complaints procedure, a copy of which is on the notice board, and all service users get a copy of this on admission with their service user guide. All staff have training in safeguarding adults` and there is a policy in place to guide staff about how to respond to any allegations of abuse. Service user surveys showed that eight out of nine would know how to raise concerns informally or make a complaint. Staff surveys showed all five who responded said they would know what to do if anyone raised any concerns with them about the home. No safeguarding adults` issues have been raised in relation to this home since the last Annual Service Review, and the AQAA stated that they had not received any complaints. Some minor issues noted on surveys to CQC were passed to the manager for her attention. The Standard relating to hygiene and control of infection was looked at and inspectors noted a number of positive points including an induction for new staff which included health and safety, infection control and the correct use of equipment. During the inspection staff were observed to change their aprons and gloves when they moved to a different task, and there were good hand washing facilities, and hand gel, availablethroughout the home. The home had no unpleasant odours, including the laundry, which was found to be clean and fresh. The inspection included visiting some communal areas including toilets, and it was noted that the underside of two raised toilet seats needed attention. The manager and the head housekeeper arranged for this to be remedied immediately, and they put in place immediate checks on all such equipment used by residents and visitors in the home. The manager agreed to review the current cleaning schedule to ensure it is sufficiently detailed in relation to the frequency and means of cleaning equipment, and that individual staff are clear about their responsibilities. Two staff recruitment files were sampled and both were found to have application forms, a documented employment history and references from previous care employers. Both also had evidence of checks against the list of those barred from working with vulnerable adults. There were also good records of staff training, and confirmation that staff had had an induction. The home is now also using the recommended Common Induction Standards (CIS) model, and the new staff member had started the CIS workbook. All staff have a personal development plan and two were seen and found to contain a good record of the training attended by staff. Further training needs were identified, including when refresher courses were due. However, the most recent staff member did not have a full employment history on file, though their recent employment history was noted and references had been taken up. The Registered Manager was asked to check that all staff who had started since July 2004 had a full employment history, and that all staff files contained the information set down in Schedule 2 of the Care Homes Regulations 2001 (as amended). A copy of this Schedule was taken by the manager and she said she will use this as a basis for a checklist at the front of each staff file. Regarding the management of the service, the AQAA notes that the Registered Manager has an NVQ4 in care and management, and the management team regularly analyse the quality of the service and will act on feedback. The manager said she ensures compliance with relevant legislation. Random and annual surveys are used, as well as monthly meetings for residents. On the day of the inspection there were no obvious health and safety issues. Staff training records that were sampled showed staff had had training in relevant areas including health and safety, moving and handling and safeguarding adults. At the last Environmental Health Officer`s visit in September 2009, some minor issues were noted and the manager said these had now been remedied including replacing a fridge seal. Staff were participating in the `Safer food, better business` coaching provided by the local authority. Surveys from service users commented favourably on the home and management; as did the staff surveys. All five staff ticked that they had regular support from their manager. Surveys were received from nine from service users (most of whom had assistance from their relatives to complete them). All ticked that they either `Usually or `Always` got the care and support they needed, and that staff were either `Always` or `Usually` available when they needed them. All nine had ticked that they `Always` got the medical attention they needed.Many compliments were received on these surveys. Comments included: `We are confident that his needs are being met. He is very happy here and has put on weight and looks much better than when he arrived.` (Relative) `A caring environment.` (Service user) `Keep up the good work to bring more homes up to the standard of this one.` (Service user) `Very kind, caring staff. Ongoing medical issues followed up well.` (Relative) `Boulter`s Lock is a first class residential home. The staff are always kind and considerate. They will always listen to your concerns.` (Service user) `Very friendly and genuinely caring staff, and this includes housekeeping staff as well as carers.` (Relative) `Adapts t What the care home could do better: One Requirement was made as a result of this inspection relating to ensuring that all the information required by legislation is kept on file for each staff member. Random inspection report Care homes for older people Name: Address: Boulters Lock Residential Home 56 Sheephouse Road Maidenhead Berkshire SL6 8HP three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Helen Dickens Date: 1 8 0 5 2 0 1 0 Information about the care home Name of care home: Address: Boulters Lock Residential Home 56 Sheephouse Road Maidenhead Berkshire SL6 8HP 01628634985 01628777808 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Carole Dawn Grace Type of registration: Number of places registered: Conditions of registration: Category(ies) : Boulters Lock Residential Home Limited care home 32 Number of places (if applicable): Under 65 Over 65 0 32 dementia old age, not falling within any other category Conditions of registration: 32 0 The maximum number of service users to be accommodated is 32. The registered person may provide the following category of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP). Date of last inspection Care Homes for Older People Page 2 of 9 Brief description of the care home Boulters Lock is registered to provide care and accommodation for up to 32 people, some of whom may have dementia. The home is a large detached house set within a private residential road, close to a picturesque area by the River Thames, and is close to the amenities that Maidenhead town has to offer. There is parking at the front of the house for several vehicles, and to the rear is a pleasant, small mature garden with a patio and newly terraced area, and seating that can be accessed from the lounges and dining room. Fees range from £699-£795 per week. Care Homes for Older People Page 3 of 9 What we found: This unannounced Random Inspection was made to Boulters Lock as the home has not had a visit from the Commission for three years; this is because they have been rated as excellent since 2007. The inspection lasted for three hours and was carried out by Mrs. Helen Dickens and Mrs. Stella Franklin, Regulatory Inspectors. The Registered Manager, Mrs. Carole Grace and the Deputy Manager, represented the establishment. Evidence and observations relating to the following were noted: personal and health care needs of residents; the safe administration of medication; complaints and safeguarding; management; and health and safety. These covered the areas the Commission deems to be most important to the safety of residents. What the care home does well: The Annual Quality Assurance Assessment (AQAA) was completed by the home and returned to the Commission within the agreed time frame. The AQAA noted that the home uses a person centred approach and care plans are reviewed on a monthly basis. Staff are trained to treat service users as individuals and maintain the privacy and dignity of service users. The home has a policy on the safe administration of medication, only those trained to administer medication are allowed to do so, and the manager ensures policies and procedures are followed. One inspector looked at a sample of care plans whilst these were being up-dated by staff. They were found to be well done, and contained a good level of detail about residents needs. A medication administration session was observed and found to comply with and reflect the homes policy for the safe administration of medication. A recent pharmacists visit report was seen and it had noted a few areas for improvement. The manager said these actions had now been completed. The AQAA noted there are a number of ways for service users to air their views or to make a complaint, including regular service user meetings. There is a clear and accessible complaints procedure, a copy of which is on the notice board, and all service users get a copy of this on admission with their service user guide. All staff have training in safeguarding adults and there is a policy in place to guide staff about how to respond to any allegations of abuse. Service user surveys showed that eight out of nine would know how to raise concerns informally or make a complaint. Staff surveys showed all five who responded said they would know what to do if anyone raised any concerns with them about the home. No safeguarding adults issues have been raised in relation to this home since the last Annual Service Review, and the AQAA stated that they had not received any complaints. Some minor issues noted on surveys to CQC were passed to the manager for her attention. The Standard relating to hygiene and control of infection was looked at and inspectors noted a number of positive points including an induction for new staff which included health and safety, infection control and the correct use of equipment. During the inspection staff were observed to change their aprons and gloves when they moved to a different task, and there were good hand washing facilities, and hand gel, available Care Homes for Older People Page 4 of 9 throughout the home. The home had no unpleasant odours, including the laundry, which was found to be clean and fresh. The inspection included visiting some communal areas including toilets, and it was noted that the underside of two raised toilet seats needed attention. The manager and the head housekeeper arranged for this to be remedied immediately, and they put in place immediate checks on all such equipment used by residents and visitors in the home. The manager agreed to review the current cleaning schedule to ensure it is sufficiently detailed in relation to the frequency and means of cleaning equipment, and that individual staff are clear about their responsibilities. Two staff recruitment files were sampled and both were found to have application forms, a documented employment history and references from previous care employers. Both also had evidence of checks against the list of those barred from working with vulnerable adults. There were also good records of staff training, and confirmation that staff had had an induction. The home is now also using the recommended Common Induction Standards (CIS) model, and the new staff member had started the CIS workbook. All staff have a personal development plan and two were seen and found to contain a good record of the training attended by staff. Further training needs were identified, including when refresher courses were due. However, the most recent staff member did not have a full employment history on file, though their recent employment history was noted and references had been taken up. The Registered Manager was asked to check that all staff who had started since July 2004 had a full employment history, and that all staff files contained the information set down in Schedule 2 of the Care Homes Regulations 2001 (as amended). A copy of this Schedule was taken by the manager and she said she will use this as a basis for a checklist at the front of each staff file. Regarding the management of the service, the AQAA notes that the Registered Manager has an NVQ4 in care and management, and the management team regularly analyse the quality of the service and will act on feedback. The manager said she ensures compliance with relevant legislation. Random and annual surveys are used, as well as monthly meetings for residents. On the day of the inspection there were no obvious health and safety issues. Staff training records that were sampled showed staff had had training in relevant areas including health and safety, moving and handling and safeguarding adults. At the last Environmental Health Officers visit in September 2009, some minor issues were noted and the manager said these had now been remedied including replacing a fridge seal. Staff were participating in the Safer food, better business coaching provided by the local authority. Surveys from service users commented favourably on the home and management; as did the staff surveys. All five staff ticked that they had regular support from their manager. Surveys were received from nine from service users (most of whom had assistance from their relatives to complete them). All ticked that they either Usually or Always got the care and support they needed, and that staff were either Always or Usually available when they needed them. All nine had ticked that they Always got the medical attention they needed. Care Homes for Older People Page 5 of 9 Many compliments were received on these surveys. Comments included: We are confident that his needs are being met. He is very happy here and has put on weight and looks much better than when he arrived. (Relative) A caring environment. (Service user) Keep up the good work to bring more homes up to the standard of this one. (Service user) Very kind, caring staff. Ongoing medical issues followed up well. (Relative) Boulters Lock is a first class residential home. The staff are always kind and considerate. They will always listen to your concerns. (Service user) Very friendly and genuinely caring staff, and this includes housekeeping staff as well as carers. (Relative) Adapts to the residents changing needs. Warm ambiance and happy atmosphere. (Relative) They treat residents with respect. I dont think families can fully appreciate how excellent is the care at Boulters Lock unless their loved one has been in a different home or hospital as we have experienced. (Relative) Staff surveys showed all five thought their induction covered everything they needed to know, they had had relevant training, and there were usually or always enough staff. Positive comments were made about working at the home including: We offer a wide range of activities and facilities for people of all needs, and endeavour to create and maintain a friendly family atmosphere. Staff kept up to date with all relevant training, and good team working among staff and management. It is a pleasant home to work in and I feel very proud to work with such hard working and dedicated staff. Residents needs are met and daily wishes respected. It is a kind, caring environment. Ive worked in other caring environments before, but Boulters Lock is the most professional by far. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 19 All the information relating to 17/06/2010 staff recruitment records, contained in Schedule 2 of the Care Homes Regulations 2001 (as amended), must be obtained, kept on file, and be made available for inspection. For the welfare of service users. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 26 The home should review the current cleaning schedule and ensure there is sufficient detail in relation to the method and frequency of cleaning (particularly equipment which is for the use of residents and visitors), and that staff understand their responsibilities. Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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